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The Lancet Countdown: Tracking Progress on Health and Climate Change is a global, interdisciplinary research collaboration which has published an annual review since 2016. The Lancet Countdown’s 2017 Report tracks 40 indicators across five areas, and concludes that the human symptoms of climate change are unequivocal and potentially irreversible. Of particular interest, Indicator 1.3 states that “global physical labour capacity in populations exposed to temperature change has decreased by around 5.3% between 2000 and 2016.” Other alarming statistics: between 2000 and 2016, the number of vulnerable people exposed to heatwave events has increased by around 125 million; without further action against climate change, over 1 billion people may be at risk of become climate change migrants by the end of the century. The full report is available here (registration required, free).

In addition to the global report, the Lancet Countdown produces country-specific reports; the Briefing for Canadian Policy-makers was written in partnership with the Canadian Public Health Association. It makes several recommendations for Canadian action, including • Phase out coal-powered electricity in Canada by 2030 or sooner, with a minimum of two thirds of the power replaced by non-emitting sources, and any gap made up by lowest-emitting natural gas technology. Track and cost the health benefits of the transition in Canada and globally; • Develop a National Active Transport Strategy for Canada to coordinate improvements to walking, cycling and transit environments. This should receive priority funding, with healthcare cost savings calculated in order to demonstrate the cost offset of the investments. • Enhance support for telecommuting and telehealth options. Within health systems, gather and analyze data on kilometers, greenhouse gas emissions, air pollution and costs saved by telehealth in order to help drive systems change. • Increase funding for research into the local health impacts of resource extraction, with a focus on impacts on Indigenous populations.• Integrate Health Impact Assessments as a core component of the federal Environmental Assessment process.

The June 2017 report, Costs of Pollution in Canada: Measuring the impacts on families, businesses and governments reviews and synthesizes existing studies to produce the most comprehensive assessment of pollution and its costs in Canada to date. Some quick facts: the cost of climate change-related heat waves in Canada is estimated to have been $1.6 billion in 2015; Smog alone cost Canadians $36 billion in 2015. But the report also provides detailed estimates, organized in three categories: 1. Direct Welfare Costs: (Harm to health and well-being such as lower enjoyment of life, sickness and premature death); 2. Direct Income Costs – (Direct out of pocket expenses for families (e.g. medications for asthma), businesses (e.g. increased maintenance costs for buildings) and governments (remediation of polluted sites); and 3. Wealth impacts.

Direct Welfare Costs of pollution, the most studied and understood, are estimated as at least $39 billion in 2015, or about $4,300 for a family of four. The Direct Income Costs that could be measured amounted to $3.3 billion in 2015, but the study cautions that this many important costs could not be measured, and full impacts on income were likely in the tens of billions of dollars. In this category, the study estimates Lost Labour Outputs, using a metric derived from the 2016 OECD study, The Economic Consequences of Outdoor Air Pollution. The OECD estimates outdoor air pollution to cost 0.1% of national GDP, which, when applied to Canada’s 2015 GDP of approximately $1,986 billion, implies a costs of about $2 billion in lost labour output alone. And finally, Wealth impacts, or costs on value of assets , are said to be the least understood of pollution costs, about which, “We simply do not know how much pollution costs us in terms of lost wealth”.

Mental Health and Our Changing Climate: Impacts, Implications, and Guidance is a report released at the end of March by the American Psychological Association, Climate for Health, and ecoAmerica. The goal is to raise public awareness of the issue and to provide “climate communicators, planners, policymakers, public health professionals, and other leaders the tools and tips needed to respond to these impacts and bolster public engagement on climate solutions.” Although it doesn’t directly address workplace issues, much of the discussion is relevant. For example, the report catalogues the acute mental health impacts that result from the horror and disruption of natural disasters or extreme weather events such as Hurricane Katrina – depression, disrupted social relationships, domestic violence, and heightened intergroup aggression. The report also highlights women as being at higher risk: “because, on average, women have fewer economic resources than men, women may also be more affected, in general, by the stress and trauma of natural disasters.” (p.39).

Extreme weather and disasters focus attention, but there are also chronic impacts resulting from longer- term climate changes – the key example given is a proven increase in violence and inter-personal aggression associated with higher temperatures. Certain occupational groups are highlighted for their high risk to climate-related anxiety, including first responders to natural disasters, but also including health care-givers, and those directly employed in natural settings – conservation officers, park rangers.

The final section of the report deals with tips to build resilience at the individual and community level. It urges that training be provided for first responders so that they can identify and deal with appropriate compassion for the victims of natural disasters.

The report gives only a nod to the threats in the workplace, given its goal to reach a general audience. It warns that “anyone can be harmed by extreme heat, but some people face greater risk. For example, outdoor workers, student athletes, city dwellers, and people who lack air conditioning (or who lose it during an extended power outage) face greater risk because they are more exposed to extreme heat. People with chronic conditions such as cardiovascular and respiratory diseases, and those who work or play outside, are especially vulnerable to extreme heat.. ..” The report also touches on the other major health-related impacts, such as spread of infectious diseases borne by ticks and mosquitos, air pollution, effects of forest fires, polluted air and food, mental health burden, etc.

The Consortium states that “most physicians are aware of the adverse health effects of climate change and feel a responsibility to inform the public, patients and policymakers about them. A majority of survey respondents report they are already seeing health harms from climate change among their own patients – most commonly in the form of increased cardiorespiratory disease (related to air quality and heat), more severe and longer lasting allergy symptoms, and injuries attributed to extreme weather.”

The goal of the consortium is to educate, and to advocate for reduced fossil fuel consumption and increased clean energy. Their website offers a library of publications related to the growing literature on climate change and health. The website also compiles resources from their member societies, such as the American College of Physicians and the American Academy of Pediatrics, about how to green medical workplaces. In this, they join a number of existing associations such as Practice Greenhealth and Healthcare without Harm, an international organization with Canadian membership.

In addition to a commitment to phase out coal-fired power by 2030, on September 14, the Government of Alberta announced a firm target to generate 30 per cent of its electricity from renewable sources such as wind, hydro and solar by 2030. The government press release associates this target with a projection that “at least $10.5 billion in new investment will flow into the provincial economy by 2030. This will mean at least 7,200 new jobs for Albertans as projects are built.” The health benefits of shutting down coal plants are highlighted in Breathing in the benefits: How an accelerated coal phase-out can reduce health impacts and costs for Albertans, a joint report from the Pembina Institute, the Canadian Association of Physicians for the Environment, the Lung Association of Alberta and NWT, and the Asthma Society of Canada, released on September 14.

On September 19, the government appointed a Task Force, to be chaired by Gordon Lambert, to make recommendations on targeting investments in climate technology to help transition to a lower-carbon economy. Submissions are invited; a report will be submitted by the end of November, summarizing the findings of the engagement and providing recommendations for a provincial Climate Change Innovation and Technology Framework. Also underway: an Energy Efficiency Advisory Panel which was launched in June 2016 (see the Discussion Document here ) and an Oil Sands Advisory Group . But not all is renewable in Alberta: on September 15, the government announced early stage approval of 3 new oil sands projects, representing “ about $4 billion of potential investment into Alberta’s economy and about 95,000 barrels per day of production”. The proposed developments will still undergo further environmental reviews and will fall under the oil sands 100 megatonne greenhouse gas emissions limit, announced with Alberta’s Climate Leadership Plan.